How did gluten, a naturally-occurring protein found in wheat, barley and rye – sources of nutrition for people over thousands of years, become so unhealthy?
Many scientists attribute the increase in Celiac Disease (CD) and non-Celiac Gluten Sensitivity (GS) to alternations in wheat’s biological structure, the result of modern farming and bread-making practices and the chemicals used today. The result: wheat crops that are biochemically different from the virgin wheat of agrarian society. Because our bodies have not adapted to these chemically treated crops, we’re unable to digest them properly.
Modern bread-making has gone from being a simple four-ingredient wholesome loaf of sustenance to being a less-nutrient dense squishy loaf of preservatives. Old-fashioned baking involved giving flour time to absorb as much water as possible, and waiting for yeast and bacteria to activate the dough (fermentation). Today, industrialized baking replaces natural hydration, fermentation and kneading with artificial additives and massive mixers to accelerate dough formation. To endure commercial processing and increase shelf life, additional concentrated vital wheat gluten and preservatives are stuffed into bread products.
One in 133 adults and children have CD, a genetic, autoimmune disorder that occurs in response to ingesting gluten, triggering the immune system to attack the delicate lining of the small intestine. This creates inflammation and can lead to nutrient malabsorption and secondary health problems. There are over 200 symptoms for CD, including:
- extreme abdominal pain
- nausea, vomiting
- gas, constipation, diarrhea
- joint pain, anemia, fatigue
- stunted growth, skin rashes
- behavior disorders, mood disturbances
Symptoms can begin immediately and last from a few hours to several days. The primary treatment for CD is a life-long gluten-free diet.
Non-celiac Gluten Sensitivity (Gluten Intolerance)
Non-celiac Gluten Sensitivity (GS) affects 6-7% of the U.S. population. It’s an adverse food-induced reaction that seems to have an immune component. Gluten activates an inflammatory response that can affect tissues anywhere in the body. Symptoms vary based upon individual and environmental factors. Determining if you have GS requires testing to rule out CD. Blood/genetic tests are not available for directly assessing GS. Currently, holistic doctors use a Food Sensitivity Panel to identify reactions to wheat. Also, an elimination diet with symptom monitoring can assess GS.
Testing for CD
A genetic test (Celiac HLA) indicates your risk for developing CD. If a first-degree family member has CD, a negative gene test excludes you from the possibility of developing it.
Blood tests require that you continue eating gluten products in order to get an accurate result. (Abstaining from gluten will skew the results.) Your practitioner will determine the amount of time required to eat gluten prior to testing. The tTg-IgA (Tissue Transglutaminase Antibodies) test looks for antibodies toward gluten. Your holistic physician may order a panel of antibody tests to assess if you are deficient in antibodies the body needs, or if the body is creating antibodies against its own tissues.
An endoscopic biopsy might be ordered to obtain a definitive diagnosis of CD. In this procedure, performed by an M.D. who specializes in digestive disorders, a part of the small intestine is removed and examined for damage.
Based on your symptoms and test results, your holistic physician can determine the type of testing you need and design an appropriate, personalized treatment plan.
- Anderson, J. “What is Gluten?” Posted 27 Feb 2018 at VeryWellHealth.com. Accessed 11 Mar 2018: https://www.verywell.com/what-is-gluten-562670
- Anderson, J. “Celiac Disease v. Gluten Sensitivity?” Posted 12 Feb 2018 at VeryWellHealth.com. Accessed 11 Mar 2018: https://www.verywell.com/gluten-sensitivity-vs-celiac-disease-562964
- Celiac.org: Celiiac Disease Foundation. “Screening.” Accessed 13 March 2018: https://celiac.org/celiac-disease/understanding-celiac-disease-2/diagnosing-celiac-disease/screening/
- D’Adamo,P. “Database of Blood Group Correlations to Common Diseases: Celiac Disease.” Accessed 13 Mar 2018: http://www.dadamo.com/btdisease/PathType-read.pl?show=30
- Fasano A. A Clinical Guide to Gluten-Related Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2014.
- FARE. Food Allergy Research & Education. https://www.foodallergy.org/allergens/wheat-allergy 2017. Accessed 13 Mar 2018.
- Gluten Intolerance Group: “Celiac Disease, Non-Celiac Gluten Sensitivity Or Wheat Allergy: What Is The Difference?” Accessed 13 Mar 2018: https://www.gluten.org/resources/getting-started/celiac-disease-non-celiac-sensitivity-or-wheat-allergy-what-is-the-difference/
- Lebwohl, B., Ludvigsson, J.F. & Green. P., “Celiac Disease and Non-Celiac Gluten Sensitivity.” The BMJ 351 (2015): h4347. Accessed: 13 Mar. 2018: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596973/
- Sapone, A., Leffler, D.A., & Mukherjee, R. “Non-Celiac Gluten Sensitivity: Where are We Now in 2015?” Nutrition Issues in Gastroenterology, (2015 June) Series #142. Accessed 13 Mar. 2018: https://www.practicalgastro.com/pdf/June15/Non-Celiac-Gluten-Sensitivity-Where-are-We-Now-in-2015.pdf
- Ontiveros N, Hardy MY, Cabrera-Chavez F. “Assessing of Celiac Disease and Nonceliac Gluten Sensitivity.” Gastroenterology Research and Practice. (2015 Apr 29) 2015:723954. Accessed 13 Mar. 2018: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429206/
- Murray, M.T. “Celiac Disease.” As cited in in Pizzorno, Joseph E & Murray, Michael T. (Ed). Textbook of Natural Medicine 4th ed. (2013). Chapter 155, p. 1281-1284. St. Louis, MO Elsevier.
- Perlmutter, D. Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar-Your Brain’s Silent Killers. (2013) https://www.drperlmutter.com/about/grain-brain-by-david-perlmutter/
- Online Resources: drperlmutter.com: Celiac Disease. https://www.drperlmutter.com/?s=celiac+disease
- Kirgel A, Lebwohl B. “Nonceliac Gluten Sensitivity.” Advances in Nutrition (2016 Nov) 15;7(6):1105-1110. Accessed 13 Mar 2018: http://europepmc.org/articles/pmc5105039
- University of Chicago Medicine Celiac Disease Center. Accessed Mar 12 2018: http://www.cureceliacdisease.org/
- Specter, M. “Against the Grain: Should you go gluten-free.” The New Yorker online. Accessed 10 March 2018: https://www.newyorker.com/magazine/2014/11/03/grain
- Barker, Jennifer M., and Edwin Liu. “Celiac Disease: Pathophysiology, Clinical Manifestations and Associated Autoimmune Conditions.” Advances in pediatrics 55 (2008): 349–365. PMC. Accessed: 12 Mar. 2018: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775561/